Study Advances Efforts to Screen all Children for Type 1 Diabetes

Researchers from the Johns Hopkins University School of Medicine, Stanford University and the University of Florida report the development of a novel antibody detection technology that holds promise for improving the accuracy of diagnostic tests for type 1 diabetes in young children and making populationwide screening practical.

In a report on the work, published in the Proceedings of the National Academy of Sciences, the scientists have said that the technology enables screening for more autoimmune antibodies implicated in type 1 diabetes than current tests by incorporating a full-length pancreatic protein, called the pancreatic zinc transport 8 (ZnT8), that is targeted for autoimmune attack in people with the disease. By improving the accuracy of this test, researchers hope to catch the disease earlier and extend testing to all people.

Type I diabetes, once known as juvenile diabetes, is a relatively rare form of the disorder in which the pancreas produces no insulin.

‘Although current tests are about 94 per cent accurate in detecting the antibodies years before children and young adults lose all blood sugar control, they are not accurate enough to rely upon for population-wide screening, so current antibody testing is limited to confirming diagnosis in symptomatic children and adults. Increasing the test accuracy will help expand screening for asymptomatic type 1 diabetes into the general population,’ explained Dax Fu, PhD, Associate Professor of Physiology at the Johns Hopkins University School of Medicine.

At the clinical on-set of type 1 diabetes, most children and young adults develop symptoms, such as fainting, exhaustion, vomiting and confusion. And by then, a large majority of pancreatic beta cells may already be lost.

‘Presymptomatic diagnosis will provide the benefit of beginning preventative therapies,’ said Fu.

Fu hopes the new technology will ultimately be combined with current tests to reach the critical 99 per cent accuracy to begin implementing type 1 diabetes tests across the entire population. However, further research is required to improve the design before it becomes clinically available.